Facility Evaluation Report

Licensing Program Analysts (LPA) Jerome Haley made an announced visit for the purpose of conducting a pre-licensing evaluation. LPA Haley was greeted and granted entry by applicant by staff. During the inspection, LPA Haley met with applicants Lito Rodriguez, Maria Gingras and Administrator Jeremias Jabonero.

Initial application: To operate an Adult Residential Care Facility, with a total capacity of 4, of which 3 will be ambulatory clients, and 1 bedridden client was submitted to the department for licensure.

Fire clearance: Orange County Fire Authority granted the Fire Clearance May 28, 2024

Structure: The facility is a single level structure, with an attached garage. There’s a total of 5 bedrooms, 4 of which will be used for clients and 1 room will be used as a staff office space. There’s one living room space, one dining room, and two bathrooms for clients. Bedrooms (Clients): All bedrooms have the required furnishings: bed, lamp, chair, and storage space. An additional supply of linens for each client is stored in the bedroom. Bathroom(s): Bathrooms are equipped with a working toilet, wash basin, and shower. Grab bars were tightly secured. Hot Water Temperature in Bathroom #1 was measured at 111.9 degrees Fahrenheit and 111.5 degrees Fahrenheit. Kitchen: The gas stove was operational, and all burners were in good working order. Client medications will be stored in cabinets above the counter tops near the refrigerator. Next to the locked medication cabinets, there’s additional locked cabinets with a lock box for refrigerated medications, and two first aid kits with all the required elements. Food Service: A sample menu was observed on the refrigerator and posted on the facility postings board at the entrance of the facility. The applicant is familiar with the perishable and nonperishable food supply requirements.